静脉注射人免疫球蛋白联合雾化吸入干扰素对重症手足口病患儿疗效、康复进程、免疫炎症指标、心肌酶的影响  

Effects of IVIG Combined with Atomized Interferon on Therapeutic Effect,Rehabilitation Process,Immunoinflammatory Indexes and Myocardial Enzymes in Children with Hand,Foot and Mouth Disease

作　　者：刘召璞 乔小亚 刘丽敏 王云茹 刘欣跃 郝现伟 LIU Zhaopu;QIAO Xiaoya;LIU Limin;WANG Yunru;LIU Xinyue;HAO Xianwei(Department of Pediatrics,Xingtai Central Hospital,Xingtai,Hebei 054000,China)

机构地区：[1]邢台市中心医院儿科,河北邢台054000

出　　处：《临床误诊误治》2025年第5期66-70,共5页Clinical Misdiagnosis & Mistherapy

基　　金：邢台市重点研发计划自筹项目(2022ZC202)。

摘　　要：目的探讨静脉注射人免疫球蛋白(IVIG)联合雾化吸入干扰素对重症手足口病患儿疗效、康复进程、免疫炎症指标、心肌酶的影响。方法选取2022年1月至2024年7月就诊的136例重症手足口病患儿,采用随机数字表法分为观察组和对照组各68例。2组均给予基础治疗,在此基础上对照组给予雾化吸入干扰素治疗,观察组给予IVIG联合雾化吸入干扰素治疗,均治疗3 d。比较2组疗效和康复进程指标(疱疹、发热、口腔溃疡消退时间及住院时间),治疗前后免疫指标[CD3+、CD4+、CD4+/CD8+、免疫球蛋白A(IgA)、免疫球蛋白E(IgE)、免疫球蛋白G(IgG)],治疗前后炎性指标[白细胞介素-2(IL-2)、白细胞介素-6(IL-6)、白细胞介素-10(IL-10)、肿瘤坏死因子-α(TNF-α)],治疗前后心肌酶[心肌型肌酸激酶同工酶(CK-MB)、乳酸脱氢酶(LDH)],以及治疗期间不良反应。结果观察组总有效率为94.12%(64/68)高于对照组的80.88%(55/68),差异有统计学意义(P<0.05)。观察组发热、疱疹、口腔溃疡消退时间及住院时间均较对照组短(P<0.01)。治疗3 d后,2组CD3+、CD4+、CD4+/CD8+、IgA、IgE、IgG均升高,且观察组高于对照组(P<0.05,P<0.01)。治疗3 d后,2组IL-2、IL-6、IL-10、TNF-α及CK-MB、LDH均降低,且观察组低于对照组(P<0.05,P<0.01)。2组治疗期间不良反应发生率比较差异无统计学意义(P>0.05)。结论IVIG联合雾化吸入干扰素可提升重症手足口病患儿疗效,加速康复进程,抑制炎症反应,增强免疫功能,减轻心肌损伤,且安全性高。Objective To investigate the effects of intravenous human immunoglobulin(IVIG)combined with aerosol inhalation of interferon on therapeutic effect,rehabilitation process,immunoinflammatory indexes and myocardial enzymes in children with severe hand,foot and mouth disease.Methods 136 children with severe hand,foot and mouth disease treated from January 2022 to July 2024 were selected and divided into observation group and control group with 68 cases in each group by random number table method.Both groups were given basic treatment,on the basis of which the control group was given atomized inhaled interferon therapy,and the observation group was given IVIG combined with atomized inhaled interferon therapy for 3 days.The therapeutic effect and recovery process indexes(herpes,fever,oral ulcer resolution time and hospital stay),and immune indexes[CD3+,CD4+,CD4+/CD8+,immunoglobulin A(IgA),immunoglobulin E(IgE),immunoglobulin G(IgG)]before and after treatment were compared between the two groups.Inflammatory indexes[interleukin-2(IL-2),interleukin-6(IL-6),interleukin-10(IL-10),tumor necrosis factor-α(TNF-α)]before and after treatment,myocardial enzyme[myocardial creatine kinase isoenzyme(CK-MB),lactate dehydrogenase(LDH)]before and after treatment,and adverse reactions during treatment.Results The total effective rate of observation group was 94.12%(64/68),which was higher than that of control group[80.88%(55/68)],suggesting significant differences(P<0.05).The regression time of fever,herpes and oral ulcer and the length of hospitalization in the observation group were shorter than those in the control group(P<0.01).After 3 days of treatment,CD3+,CD4+,CD4+/CD8+,IgA,IgE and IgG were increased in 2 groups,and the observation group was higher than the control group(P<0.05,P<0.01).After 3 days of treatment,IL-2,IL-6,IL-10,TNF-α,CK-MB and LDH in 2 groups were decreased,and the observation group was lower than the control group(P<0.05,P<0.01).There was no significant difference in the incidence of adverse reactions between

关 键 词：手足口病 儿童 人免疫球蛋白 干扰素 CD3+ 白细胞介素-2 乳酸脱氢酶 药物毒性 

分 类 号：R725.1[医药卫生—儿科]